Lisa M Mulready, PT

Key facts

NPI

1447280409

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

PT2703 (ME)

Practice address

177 Coldbrook Rd
Hampden, ME 04444

Phone

(207) 862-2088

Fax

(207) 862-2262

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Back in Motion Physical Therapy, LLC Physical Therapist · Gorham, ME · NPI 1821165960
  Medicare reassignment Care Compare group NPD ME · PHYSICAL THERAPIST
• Results Physical and Occupational Therapy Specialist · Dixmont, ME · NPI 1861469082
  NPD PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back in Motion Physical Therapy LLC (57 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in ME

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2022.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1447280409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 COLDBROOK RD",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "04444",
            "telephone_number": "207-862-2088",
            "fax_number": "207-862-2262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "797 Wilson St",
            "address_purpose": "LOCATION",
            "city": "Brewer",
            "state": "ME",
            "postal_code": "044121000",
            "country_code": "US",
            "telephone_number": "207-992-4042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULREADY",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432258499",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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